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by Steven Reinberg

FDA Approves HPV Test as Initial Screen for Cervical Cancer

Detects presence of high-risk strains of virus believed to cause disease
THURSDAY, April 24, 2014 (HealthDay News) -- The U.S. Food and Drug Administration on Thursday approved a human papillomavirus (HPV) test as a first step in cervical cancer screening for women 25 and older.
"Today's approval offers women and physicians a new option for cervical cancer screening," Alberto Gutierrez, director of the Office of In Vitro Diagnostics and Radiological Health at the FDA's Center for Devices and Radiological Health, said in an agency news release.
HPV, a sexually transmitted virus, is thought to cause the majority of cervical cancers. Certain strains, such as HPV 16 and 18, are most strongly tied to these tumors. The virus also causes genital warts in both men and women and certain head and neck cancers.
Roche Molecular Systems Inc. makes the cobas HPV test. Women who test positive for the two high-risk HPV strains (16 and 18) would then be asked to undergo a colposcopy. This involves using a device that allows a doctor to get a clear view of the vulva, vagina and cervix and take a sample for further testing.
Women who don't have HPV 16 or 18 but have other high-risk types of the virus would have a Pap test to see if a colposcopy is needed, the FDA said.
The data the FDA reviewed for its decision came from a trial that included more than 47,000 women.
The FDA first approved the cobas HPV test in 2011, to be used with or as a follow-up to a Pap test. Thursday's approval expands the use of the test as either a "co-test" or as an initial screening test for cervical cancer. But, it doesn't change current guidelines for cervical cancer screening.
According to the U.S. Department of Health and Human Services, women should have a Pap test every two years starting at age 21. Women 30 and older who've had three normal Pap tests in a row can now have one every three years. Women older than 65 may be able to stop having Pap tests but should discuss the matter first with their doctor.
Typically, an HPV infection clears up on its own and doesn't lead to health problems. But, about 10 percent of women infected with high-risk HPV develop a persistent infection that may put them at risk of cancer, the FDA said in the news release.
The FDA approval Thursday followed a unanimous vote by the agency's Medical Devices Advisory Committee Microbiology Panel in March that concluded the test was safe and effective as a first-line screen for cervical cancer.
Testifying before that expert panel, Dr. David Chelmow, chair of the department of obstetrics and gynecology at Virginia Commonwealth University School of Medicine, said that "cervical cancer screening has been a huge success in decreasing cervical cancer incidence and death."
Chelmow, representing the American College of Obstetricians and Gynecologists, added that "the college strongly supports further improving cervical cancer screening through the introduction of new paradigms such as HPV testing for primary screening. HPV testing as a primary screening method for cervical cancer is very promising, and appears effective for screening for cervical cancer."
Dr. Andrew Menzin, a gynecologic oncologist at North Shore University Hospital in Manhasset, N.Y., told HealthDay that "HPV testing has been a remarkable advance in cervical cancer screening."
Its greatest value is helping to decide whether a follow-up colposcopy is needed, he said. "The idea of reversing the order of testing is an approach to try to refine and minimize who [unnecessarily] goes on to colposcopy," he said.
Whether doctors will accept using an HPV test first instead of a Pap test will depend upon the clinical trial data supporting it and on doctors and patients being educated about it, Menzin said.
He noted that current guidelines still favor using the Pap test first, "but the guidelines continue to evolve."
There are two approved vaccines, Gardasil and Cervarix, that can protect against HPV. The U.S. Centers for Disease Control and Prevention recommends that all girls and boys be vaccinated between the ages of 9 and 11.
More information
For more on cervical cancer, visit the American Cancer Society (http://www.cancer.org/cancer/%20cervicalcancer/index ).
SOURCES: David Chelmow, M.D., chair, department of obstetrics and gynecology, Virginia Commonwealth University School of Medicine, Richmond; Andrew Menzin, M.D., gynecologic oncologist, North Shore University Hospital, Manhasset, N.Y.; April, 24, 2014, news release, U.S. Food and Drug Administration
by Steven Reinberg

FDA Proposes E-Cigarette Regulations

Opponents of the increasingly popular devices worry about their impact on children
THURSDAY, April 24, 2014 (HealthDay News) -- The U.S. Food and Drug Administration is proposing long-awaited regulations governing the fast-growing electronic cigarette industry.
The new rules, made public Thursday, would give the FDA the authority to regulate e-cigarettes as tobacco products, placing them under the same requirements as cigarettes. That would include a ban on the sale to minors.
The new proposed regulations would also give the FDA oversight of numerous tobacco products that up to now have had no federal oversight. Those products include cigars, pipe tobacco, nicotine gels and waterpipe (or hookah) tobacco.
"Today, we're taking another very important step toward the goal of a tobacco-free generation," U.S. Health and Human Services Secretary Kathleen Sebelius said during a Thursday afternoon news conference.
"We know the use of novel products like so-called e-cigs is on the rise, particularly among young people," she added. "We don't know yet the full impact and ramification these products have on our nation's health. We don't yet have a full understanding as to whether these products serve as a gateway to the use of regular cigarettes, and we don't know how they influence the behavior of current smokers."
The proposed regulations would require makers of "newly deemed" tobacco products such as e-cigarettes to:
register with the FDA and report product and ingredient listings, only market new products after an FDA review, only make claims of reduced health risks if the FDA confirms that scientific evidence supports the claim and that marketing the product will benefit public health, not distribute free samples.
In addition, the proposal would require minimum age and identification restrictions to prevent sales to underage children; require health warnings; and prohibit sales through vending machines, unless they're in a facility that never admits children.
"Tobacco remains the leading cause of death and disease in this country," FDA Commissioner Dr. Margaret Hamburg said in an agency news release. "This is an important moment for consumer protection and a significant proposal that if finalized as written would bring FDA oversight to many new tobacco products. Science-based product regulation is a powerful form of consumer protection that can help reduce the public health burden of tobacco use on the American public, including youth."
The FDA is basing its proposed regulations on the Family Smoking Prevention and Tobacco Control Act, which was signed by President Barack Obama in 2009 and gave the agency oversight of tobacco products.
The FDA said the public, the electronic cigarette industry and others will have 75 days to comment on the proposed regulations. Then the agency will review those comments before issuing a final rule.
E-cigarettes are battery-operated devices that turn nicotine, flavorings and other chemicals into a vapor that can be inhaled. Most are designed to look like a tobacco cigarette, but some look like pens, USB drives or other everyday objects.
The devices are advertised on TV and the Internet, and come in sweet flavors like green apple, watermelon and bubble gum.
Erika Sward, the American Lung Association's assistant vice president for national advocacy, applauded the FDA's proposal.
"It would give FDA authority over all unregulated tobacco products," she said. "That would be e-cigarettes, but it also would be cigars, little cigars, hookah-type tobacco and any other products that aren't currently under the FDA's authority now."
Such regulations would close a huge loophole that allows children to freely purchase e-cigarettes and little cigars in many parts of the country, according to proponents of stricter regulations.
E-cigarette use more than doubled among middle and high school students from 2011 to 2012, with more than 1.78 million students nationwide inhaling nicotine-laced vapor from the devices, the U.S. Centers for Disease Control and Prevention reported last year.
"What's concerning is that high rate of rise," said Dr. Hilary Tindle, assistant professor of medicine and director of the tobacco treatment service at the University of Pittsburgh Medical Center. "Who knows where it will be next year, or the year after that? Everyone agrees that's not a good thing. The least amount of regulation has to close that hole, so children can't get access to them as easily."
The drive for regulation is also being fueled by a dramatic increase in the number of calls to poison centers involving nicotine poisonings from e-cigarettes, according to federal health officials.
Calls related to poisoning from the liquid nicotine in the devices rose from about one a month in 2010 to 215 in February this year, the CDC reported in April.
Electronic cigarettes may be safer than conventional tobacco cigarettes, in that people don't have to inhale harmful smoke. But without regulation, it's impossible to know what people are inhaling when they use an e-cigarette, Tindle said.
"There are so many manufacturers right now making e-cigarettes, and there have been multiple reports of contaminants in the vapor and in the e-liquids," she said. "People don't necessarily know what they are getting in their bodies, based on the label."
The new regulations would end the "Wild West" nature of the e-cigarette market, Sward said.
"Once these companies come under FDA authority, it would require them to register with the FDA to disclose their products and ingredients. That's really important in understanding how these new products impact public health," she said.
Given the lack of federal action until now, some states and cities have started pursuing e-cigarette regulations of their own. New York City added e-cigarettes to the city's overall ban on smoking in December, treating them the same as tobacco products.
Some argue that e-cigarettes can help people quit smoking, but evidence supporting that claim has been mixed. Recent studies published in The Lancet and JAMA Internal Medicine have reported that e-cigarettes either don't help people quit or are about as effective as a nicotine patch.
More information
For more on e-cigarettes, visit the U.S. National Institute on Drug Abuse (http://www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes ).
SOURCES: Erika Sward, assistant vice president for national advocacy, American Lung Association; Hilary Tindle, M.D., assistant professor of medicine, and director of the tobacco treatment service, University of Pittsburgh Medical Center; April 24, 2014, news conference with Kathleen Sebelius, U.S. Health and Human Services Secretary, and Margaret Hamburg, M.D., commissioner, U.S. Food and Drug Administration; April 24, 2014, news release, U.S. Food and Drug Administration
by Steven Reinberg

FDA Reconsiders Behavior-Modifying 'Shock Devices'

Agency meets Thursday to discuss outlawing tools used on emotionally disabled kids
THURSDAY, April 24, 2014 (HealthDay News) -- They're likened to a dog's "shock collar" by some and called a "life-saving treatment" by others. But the days of electro-shock devices as a tool for managing hard-to-control behavior in people with disabilities may be numbered, U.S. health officials say.
A U.S. Food and Drug Administration panel is meeting Thursday to discuss a ban on using "electrical stimulation devices" to modify aggressive or self-injurious behavior in people with severe emotional problems or developmental disorders such as autism.
"The FDA has grown concerned that serious risks of using these devices may outweigh the benefits for patients with limited intellectual ability or developmental disabilities, and that they may pose an unreasonable and substantial risk of illness or injury to patients," agency spokeswoman Jennifer Rodriguez said.
The zapping devices are used as an "aversion therapy" technique at a center in Massachusetts that serves children and adults with serious special needs.
To its knowledge, the Judge Rotenberg Educational Center in Canton, Mass., is the only facility using the devices in an attempt to change behavior, the FDA said in background material released prior to the meeting.
Former Rotenberg students told FDA investigators that they were burned by the devices, and felt anxiety, fear and depression.
It feels "like a thousand bees stinging you in the same place for a few seconds," said one former student, adding the device "is torture, in the plainest sense of the word."
Proponents of the shock technique say it discourages aggressive or self-injurious behavior. The students will stop punching themselves or others, for instance, to avoid being zapped, the thinking goes.
But the student told the FDA he received shocks "for things like noncompliance with staff direction, talking too much and being disruptive in class."
Meanwhile, the Rotenberg Center stands by its policy. The devices, usually applied to the arms or legs, deliver a two-second shock that "feels like a hard pinch but is otherwise harmless and has no side effects," the center said in a statement.
"Without the treatment program at JRC, these children and adults would be condemned to lives of pain by self-inflicted mutilation, psychotropic drugs, isolation, restraint and institutionalization -- or even death," the statement from the center said.
The goal is to manage behaviors so these patients "can learn, and spend time with their family and friends," the statement said.
The center makes its own devices on-site and does not offer them for sale. The devices are used only with prior parental consent or authorization from a Massachusetts probate court, the statement said.
Disability advocates have urged the FDA to ban these controversial tools. The United Nations has said use of electro-shock devices by the Rotenberg Center constitutes a violation of the UN Convention Against Torture, according to the FDA report.
"It's like putting a shock collar on a dog," said Margaret Nygren, executive director of the American Association on Intellectual and Developmental Disabilities. "It's designed for them not to be able to remove it. It's just degrading."
These types of devices have been around for decades, and there currently are four FDA-approved models. Two similar devices are approved for use in smoking cessation and stopping nail biting, but those are not being considered for the ban.
The instruments in use at the Rotenberg Center lack FDA approval because they have been substantially modified from earlier models. One device "has an average output current that is almost three times that" of the FDA-approved model, the agency said.
Studies have shown that negative reinforcement does not provide a long-term solution to behavior problems in developmentally disabled people, Nygren said.
"In the long run, as the punishment is removed, the behaviors return," she said.
A better strategy involves figuring out why the behavior occurs and then making changes that head off the behavior, Nygren said.
For example, a student might be hurting himself because he is hungry but can't think of how to communicate that need. Once instructors figure this out, they can come up with other ways for the person to communicate -- for example, by providing a card he can hold up when he is hungry.
"It takes a little bit longer to do than attaching a shock device to someone, but in the long run the individual has much better outcomes," Nygren said.
But dozens of parents with children at the Judge Rotenberg Center argue otherwise in letters of support submitted to the FDA.
"Our kids are one punch away from going blind or killing themselves and need treatments that work quickly with minimal side effects," wrote the parents of a daughter with a rare form of epilepsy. "It would be a terrible injustice to deprive a child of such an effective life-saving treatment when all other available treatments have consistently failed."
More information
To read the government report on a potential ban of electrical stimulation devices, visit the FDA ( http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/NeurologicalDevicesPanel/UCM394256.pdf ).
SOURCES: U.S. Food and Drug Administration, executive summary report, April 21, 2014; Jennifer Rodriguez, U.S. Food and Drug Administration, spokeswoman; Margaret Nygren, executive director, American Association on Intellectual and Developmental Disabilities; April 22, 2014, statement, Judge Rotenberg Educational Center, Canton, Mass.
by Steven Reinberg

Workplace Ladder Falls a Major Cause of Deaths, Injuries: CDC

There were 113 ladder-related deaths, more than 34,000 ER-treated injuries in 2011 alone
THURSDAY, April 24, 2014 (HealthDay News) -- Workplace tumbles off of ladders are a major cause of injury and death among American employees, a new study says.
"Falls remain a leading cause of unintentional injury [deaths] nationwide, and 43 percent of fatal falls in the last decade have involved a ladder," say a team led by Christina Socias of the U.S. Centers for Disease Control and Prevention.
Overall, "among workers, approximately 20 percent of fall injuries involve ladders," they added.
In the study, Socias and colleagues analyzed U.S. national data for 2011. They found that work-related ladder falls caused 113 deaths, almost 15,500 nonfatal injuries that resulted in at least one day away from work, and about 34,000 nonfatal injuries that were treated in hospital emergency departments.
Workers at greatest risk for ladder fall injuries include men, older employees, Hispanics and those in the fields of construction, extraction (such as mining), installation, maintenance and repair.
"Among construction workers, an estimated 81 percent of fall injuries treated in U.S. emergency departments involve a ladder," the researchers noted.
Most of these injuries could have been prevented, however. Socias and her colleagues urge employers, safety experts and health care professionals to work together to make safe ladder use training available to people both on and off the job.
The authors also called for research into workplace ladder fall prevention, including developing and distributing new technologies to reduce the risk of ladder-related injuries. In the meantime, they said, a few simple steps at the worksite could help prevent ladder falls, including:
Find ways to complete most of the work needed on the ground, without the use of ladders; Provide workers with alternatives to ladders, such as aerial lifts or supported scaffolds; Make sure ladders are "thoroughly inspected," have appropriate safety accessories, and are well matched to a worker's weight, task and location; Provide on-the-job ladder safety training and information.
The study appears in the April 25 issue of the Morbidity and Mortality Weekly Report, published by the U.S. Centers for Disease Control and Prevention.
More information
The U.S. Consumer Product Safety Commission offers ladder safety tips (https://www.cpsc.gov/onsafety/2011/12/ladder-safety-101/ ).
SOURCE: U.S. Centers for Disease Control and Prevention, news release, April 24, 2014
by Steven Reinberg

Guidelines Aim to Detect More Congenital Heart Defects in Womb

Picking up problems before birth allows for earlier monitoring, planning, American Heart Association says
THURSDAY, April 24, 2014 (HealthDay News) -- Despite advances in technology that make it much easier for doctors to detect heart defects in fetuses, more than half of babies with heart abnormalities go undiagnosed before they're born, experts say.
A new scientific statement from the American Heart Association (AHA) seeks to improve that situation by offering updated guidelines on detecting, managing and treating heart problems in the womb.
"Congenital heart disease is the most common birth defect that can result in either death or significant health problems in newborn babies," statement lead writer Dr. Mary Donofrio, director of the fetal heart program and critical care delivery service at Children's National Medical Center in Washington, D.C., said in an AHA news release.
"We now have advanced imaging technologies, such as high-resolution ultrasound and three- and four-dimensional echocardiography, magnetic resonance imaging (MRI), fetal electrocardiography and magnetocardiography enabling physicians to diagnose fetal abnormalities early and with better detail and accuracy," she noted.
"Despite this, more than half of babies with congenital heart disease go undiagnosed before birth," Donofrio said. "We created these guidelines to provide pediatric cardiologists, obstetricians, maternal fetal specialists, radiologists, nurses and other health care providers with the latest developments in the rapidly developing area of fetal cardiology."
The statement recommends that pregnant women with certain risk factors be referred for fetal echocardiography, which uses sound waves to examine the heart of a fetus.
A variety of women may be at higher risk of giving birth to a baby with congenital heart disease, the statement noted.
Among these are women who had diabetes before pregnancy or developed diabetes in the first trimester. In addition, taking painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs) in the third trimester, having congenital heart disease or a close relative with congenital heart disease, or having other specific medical conditions are also risk factors.
Other women possibly at higher risk are those who used in vitro fertilization to get pregnant, according to the statement.
Fetuses diagnosed with a heart defect should be closely monitored and doctors should plan the care that the baby will require at and after birth, the statement advised. Some fetal heart rhythm and function abnormalities can be treated with medicines given to the mother. Surgery to correct heart problems while the baby is still in the womb are still considered experimental, the statement noted.
The statement called for health care providers to help parents and other family members deal with anxiety and depression after learning that the unborn baby has a heart defect. This can help them move from grief to acceptance.
Doctors need to be open and forthright about the problem, treatment details and likely outcomes for the children, such as whether they'll be able to play sports and what type of physical and mental support they may need.
The guidelines in the statement, published April 24 in the journal Circulation, will provide "improved care for babies with congenital heart disease, starting in the womb and continuing after delivery and through their lives," Donofrio said.
More information
The U.S. National Heart, Lung, and Blood Institute has more about congenital heart defects (http://www.nhlbi.nih.gov/health/health-topics/topics/chd/ ).
SOURCE: American Heart Association, news release, April 24, 2014
by Steven Reinberg

1 in 13 U.S. Schoolkids Takes Psych Meds: Report

More than half of parents said the drugs are helpful
THURSDAY, April 24, 2014 (HealthDay News) -- More than 7 percent of American schoolchildren are taking at least one medication for emotional or behavioral difficulties, a new government report shows.
Apparently, the medications are working: More than half of the parents said the drugs are helping their children, according to the report.
"We can't advise parents on what they should do, but I think it's positive that over half of parents reported that medications helped 'a lot,' " said report author LaJeana Howie, a statistical research scientist at the U.S. National Center for Health Statistics.
Howie and her colleagues weren't able to identify the specific disorders the children were being treated for, although she said 81 percent of the children with emotional or behavioral difficulties had been diagnosed with attention-deficit/hyperactivity disorder (ADHD) at some point in their lives.
The researchers were also unable to identify the specific medications prescribed to the children for their emotional and behavioral difficulties, according to Howie.
An expert not involved with the report agreed that ADHD likely would be one of the most common conditions involved.
"Although the authors don't really talk about the diagnoses, ADHD is likely the most overwhelming diagnosis. Oppositional defiant disorder, anxiety and depression are other likely diagnoses," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven and Alexandra Cohen Children's Medical Center of New York, in New Hyde Park.
Data for the study came from the National Health Interview Survey, which continually collects information about health and health care in the United States. All of the information on children is obtained through parental (or other guardian) responses. None of the information comes from medical records.
Overall, the researchers found that 7.5 percent of U.S. children between the ages of 6 and 17 were taking medication for an emotional or behavioral problem. Significantly more boys than girls were given medication -- 9.7 percent of boys compared with 5.2 percent of girls.
Older females were more likely than younger females to be given medication, but the age difference among males wasn't significant, according to the report.
White children were the most likely to be on psychiatric medications (9.2 percent), followed by black children (7.4 percent) and Hispanic children (4.5 percent), according to the report.
The study found that significantly more children on Medicaid or the Children's Health Insurance Program were on medication for emotional and behavioral problems (9.9 percent), versus 6.7 percent with private insurance and just 2.7 percent of children without insurance.
Additionally, more families living below 100 percent of the federal poverty level had children taking medications for emotional and behavioral problems than those above the federal poverty level.
Fifty-five percent of parents reported that these medications helped their children "a lot," while another 26 percent said they helped "some." Just under 19 percent said they didn't help at all or helped just a little.
Parents of younger children (between 6 and 11) were slightly more likely to feel the medications helped a lot compared to parents of older children. Parents of males were also more likely to feel the medications helped a lot -- about 58 percent of parents of males reported that they helped a lot compared to about 50 percent of the parents of females.
The report found that parents with incomes less than 100 percent of the federal poverty level were the least likely to feel the medications helped a lot. Just 43 percent of those parents said the medications helped a lot, while about 31 percent said they helped some. More than one-quarter of these parents said the medications only helped a little or not at all.
Of those findings, Howie said, "We really can't speculate what factors would account for the difference."
For his part, Adesman said there are many factors that might contribute to more use of medications in people living under the poverty line and for those on government insurance programs.
"There may be parenting challenges, such as more single-parent households, medications may be more available than access to behavioral treatments, there may be more logistical issues with nonpharmaceutical interventions, like getting time off from work," Adesman said. "Many more families have access to prescription medications than to non-pharmaceutical interventions. There's a lack of mental health treatment parity.
"It's encouraging that children who are identified as taking prescription medications are benefiting from those medications," Adesman said. However, he added, "There are nonpharmaceutical treatments for virtually all psychiatric diagnoses in children. For households where a child has significant emotional or behavioral difficulties, counseling, behavior management and some forms of psychotherapy can be helpful as well."
More information
Learn more about medications for childhood emotional and behavioral problems from the American Academy of Child and Adolescent Psychiatry (http://www.aacap.org/aacap/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Psychiatric_Medication_For_Children_And_Adolescents_Part_II_Types_Of_Medications_29.aspx ).
SOURCES: LaJeana Howie, M.P.H., statistical research scientist, U.S. National Center for Health Statistics, U.S. Centers for Disease Control and Prevention; Andrew Adesman, M.D., chief, developmental and behavioral pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park; April 2014, NCHS Data Brief, Use of Medication Prescribed for Emotional or Behavioral Difficulties Among Children Aged 6-17 Years in the United States, 2011-2012
by Steven Reinberg

Bullying Rates Drop Among American Teens: Study

Surveys taken over 10-year period showed roughly half as many kids were instigators
THURSDAY, April 24, 2014 (HealthDay News) -- American teens are much less likely to engage in bullying than they were a decade ago, new research suggests.
Surveys completed by middle school and high school students between 1998 and 2010 suggest that instances of both verbal and physical bullying dropped by roughly half, with much of the decline seen specifically among boys.
Study author Jessamyn Perlus, a fellow in the division of intramural population health research with the Eunice Kennedy Shriver National Institute of Child Health and Human Development, described her team's findings as "encouraging."
"In recent years, there has been more attention to anti-bullying efforts, such as prevention programs, and responses to bullying have been incorporated into school policies," Perlus noted. "We hope that these prevention efforts, and the additional attention and awareness of the problem of bullying, may be the reason for the decline."
Perlus and her colleagues reported their results in the April 17 online edition of the American Journal of Public Health.
During the study period, four surveys were conducted among a nationally representative sample of students attending grades 6 through 10. Each survey included roughly 9,000 to 16,000 teens.
Those polled were asked to indicate how much they had engaged in bullying in school during the prior two months. Bullying was defined as involving two or more people of unequal strength or power, and included verbal teasing and insulting; excluding or ignoring peers; physical abuse; the spreading of false and negative rumors; and/or making sexual jokes.
Off-campus bullying -- including cyber-bullying -- was not covered by the survey. In addition, students were asked to indicate the frequency with which they carried a weapon, such as a gun or knife.
The researchers found that weapon-carrying did not fall off during the study period, and white students were actually slightly more likely to pack a weapon in 2010 than they had been in 1998.
However, fewer students said that they had been a victim of bullying in the same timeframe, with rates dropping from nearly 14 percent to just over 10 percent. That decrease was seen primarily among boys.
An even more dramatic drop was seen among those students who said they had instigated an act of bullying. That figure fell from nearly 17 percent in 1998 to below 8 percent by 2010.
Bullying rates varied, however, when broken down by different groups. For example, while bullying among white students fell by 64 percent in the study timeframe, it dropped only 30 percent among black students.
Younger students (in grades 6 through 8) also saw bigger declines than older students (in grades 9 and 10), the findings showed.
When looked at by gender, bullying remained more common among boys than girls, with one exception: In the 2010 poll, girls were found to engage in more social ostracizing than boys.
Name-calling and social ostracizing were found to be the most common types of bullying in general, and these also saw the sharpest decline over the years, according to the report.
"However, we suspect these bullying behaviors are different in an out-of-school context," noted Perlus. "Particularly with technology that lends itself to cyber-bullying."
Stephen Russell, director of the Frances McClelland Institute for Children, Youth, & Families at the University of Arizona in Tucson, agreed with Perlus that the findings were good news.
"It is encouraging to see that the public education policy attention to bullying may be slowly paying off," he said.
Russell cautioned, however, that the study didn't touch specifically on instances of bullying that are rooted in discrimination, a tricky aspect of social ostracizing that he said students are prone to justify as "just normal."
"I've been advocating for inclusion of discrimination experiences [and] discriminatory bullying in large-scale surveys for a while now," he said. "And that, along with inclusion of cyber-bullying, will be important to understand over time."
More information
Visit the U.S. Department of Health and Human Services (http://www.stopbullying.gov ) for more on bullying.
SOURCES: Jessamyn Perlus, B.A., fellow, division of intramural population health research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, U.S. National Institutes of Health, Bethesda, Md.; Stephen Russell, director, Frances McClelland Institute for Children, Youth, & Families, College of Agriculture and Life Sciences, University of Arizona, Tucson; April 17, 2014, American Journal of Public Health, online
by Steven Reinberg

Cell-Targeted Therapy Shows Early Promise Against MS

Patients with relapsing-remitting form of the disease showed fewer brain lesions with ofatumumab
THURSDAY, April 24, 2014 (HealthDay News) -- Treatment targeting specific white blood cells in the immune system known as B cells may help people with multiple sclerosis (MS), new research suggests.
The study involved 231 people with a form of MS that's called relapsing-remitting. For these patients, there are times when their disease is very active. At other times, the condition becomes less intense and they may experience a full or partial recovery of function.
Researchers gave the participants either several low doses of a drug called ofatumumab or a harmless placebo pill. Ofatumumab is an "anti-B cell antibody" and is not yet approved for the treatment of MS. The research was funded by GlaxoSmithKline, the drug's maker.
Researchers led by GlaxoSmithKline investigator Darrin Austin analyzed the effects of this drug compared to the dummy pill on the total number of new brain lesions the patients developed over the course of 12 weeks.
The team compared the amount of B cells the participants had with the number of new brain lesions found on brain scans. Although all of the participants had lesion activity in the first four weeks, the study found that participants on any dose of anti-B cell therapy showed much less disease activity between the subsequent four- to 12-week period.
More specifically, when B cells were maintained below a certain threshold the appearance of new brain lesions was significantly reduced, the team said. On average, these participants had a rate of less than one new brain lesion per year, compared to an average of 16 lesions without treatment.
At least 5 percent of the study's participants developed side effects from the treatment over the course of the 12 weeks, including injection-related reactions, dizziness, anxiety, fever, respiratory tract infection and nerve pain.
"These results need to be validated, of course, but the findings are interesting," said Austin, who is based in Uxbridge, U.K. "They provide new insight into the mechanism of B cells in MS, and present a possible new target threshold for exploring the potential benefit of anti-B cell therapy."
Two experts in treating multiple sclerosis said the finds are intriguing.
"The data is very compelling with regard to ofatumumab's ability to limit new lesions accumulating in the brain," said Dr. Karen Blitz, director of the North-Shore LIJ Multiple Sclerosis Center in East Meadow, NY. However, she added that "further studies are needed to evaluate its effect on MS relapse rate and disability."
Dr. Fred Lublin is director of The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, at Icahn School of Medicine at Mount Sinai, in New York City. He said that if the findings were repeated in a larger study, the therapy "would be an important step forward in MS treatment."
The study was to be presented Thursday at the American Academy of Neurology's annual meeting in Philadelphia. Findings released at medical meetings are typically considered preliminary until published in a peer-reviewed journal.
More information
The U.S. National Institute of Allergy and Infectious Diseases provides more information on immune system B Cells (http://www.niaid.nih.gov/topics/immunesystem/immunecells/Pages/bcells.aspx ).
SOURCE: Fred Lublin, M.D., professor, neurology, and director, The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai, New York City; Karen Blitz, M.D., director, North Shore-LIJ Multiple Sclerosis Center, East Meadow, NY; American Academy of Neurology, news release, April 24, 2014.
by Steven Reinberg

Health Highlights: April 24, 2014

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
Older Americans Feel Younger Than Their Age: Survey
Many older Americans feel much younger than their actual age, even those who are 100 or older, a new survey finds.
The poll of 302 Baby Boomers and 104 centenarians found that, on average, 65-year-olds felt like they were 55, while those who'd lived 100 years or longer felt like they were 83, USA Today reported.
Many centenarians were upbeat about reaching 100, with 36 percent feeling blessed, 31 percent happy, and 12 percent surprised. No one said they were sad or burdened, and only 3 percent said they were lonely, according to the survey by the insurance company UnitedHealthcare.
More than half (53 percent) of centenarians said they live independently, without the support of a caregiver to assist them in daily activities, USA Today reported.
Census Bureau data shows that there are about 55,000 centenarians in the U.S., and that number is expected to rise to 442,000 in 2050.
Vermont Passes Bill Requiring Labeling on Genetically Modified Foods
Vermont is poised to become the first state to require the labeling of genetically modified foods.
The bill was passed Wednesday by the state House, following last week's approval by the Senate. Gov. Peter Shumlin said he plans to sign the bill into law, and it would take effect July 1, 2016, the Associated Press reported.
"I am proud of Vermont for being the first state in the nation to ensure that Vermonters will know what is in their food," Shumlin said in a statement.
It's expected that lawsuits will be launched by the food and biotech industries in an attempt to derail the new law. The bill sets aside $1.5 million to implement the law and to fight any legal challenges, the AP reported.
"Every Vermonter has a right to know what is in their food," said Shap Smith, speaker of the Vermont House. "Genetically engineered foods potentially pose risks to human health and the environment. I am proud to be the first state in the nation to recognize that people deserve to know whether the food they consume is genetically modified or engineered."
In recent years, 29 other states have proposed bills to require genetically modified labeling. That includes Maine and Connecticut, but their bills take effect only when neighboring states also take similar action. Neither of them are next to Vermont.
A number of surveys have shown that Americans overwhelmingly support labeling of genetically modified foods, the AP reported.
The U.S. Food and Drug Administration and a group called the Biotechnology Industry Organization claim there is no material difference between normal food and genetically modified food.
The Grocery Manufacturers Association, which represents food producers, criticized the Vermont bill, saying it "sets the nation on a costly and misguided path toward a 50-state patchwork of GMO labeling policies that will do nothing to advance the safety of consumers."
The association wants a regional approach to labeling. Having different labeling rules in 50 states, "gets very costly, very confusing and very difficult for the entire food industry to comply with," association president Jim Harrison said, the AP reported.
Ebola Death Toll in West Africa at 147: WHO
The Ebola outbreak in West Africa has killed 147 people so far, according to the World Health Organization.
More than 240 cases of the virus have been recorded in Guinea and Liberia. Most of the cases and 136 deaths have been in Guinea, while 11 people have died in Liberia, the agency said in a statement posted on its website, the Associated Press reported.
The outbreak in West Africa is unusual because Ebola typically occurs only in central or eastern Africa.
There is no vaccine or cure for Ebola, which has a high death rate and causes high fever and internal and external bleeding, the AP reported.
by Steven Reinberg

Internet May Help Seniors Avoid Depression

Social connections lessen loneliness, especially for older adults living alone, researcher says
THURSDAY, April 24, 2014 (HealthDay News) -- A basic communication tool like email can help isolated older people combat loneliness and depression, a new study suggests.
Surveys conducted between 2002 and 2008 found that far fewer retirees who said they used the Internet for communication and other purposes suffered from depression than non-Internet users.
"The key is that the Internet helps older adults stay in contact with their friends and family and to feel part of a larger community," said study lead author Shelia Cotten, a professor with the department of telecommunication, information studies and media at Michigan State University in East Lansing. "They're still actively engaged in some segment of our society, and they're not feeling like life has passed them by."
The research, recently published online in the Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, doesn't prove that using the Internet to stay in touch with faraway friends and family helps ease depression in senior citizens. But it does suggest an association between the two.
Depression affects millions of Americans older than 50, and suicide rates are highest among the elderly, according to the researchers.
For this study, they examined the results of four surveys given to 3,075 respondents in the United States who were 50 and older and not living in nursing homes.
The researchers adjusted the survey results for factors such as race and marital status, ultimately focusing on the responses from 3,058 people who were surveyed more than once.
Over the six-year period, 13 to 15 percent of respondents appeared to suffer from symptoms of depression. Only 9 percent of those who said they used the Internet for email or other purposes appeared to have symptoms of depression, compared to 16 percent of those who didn't email or surf the Web.
The researchers linked Internet use to a 33 percent lower probability of depression. And the reduction in depression was greatest for people living alone, they said.
The study's design doesn't shed light on why depression was averted. It's possible that people turned to the Internet because their depression had already lifted on its own, Cotten said.
But it's more likely, Cotten believes, that the Internet is contributing to the easing of depression symptoms, perhaps by lowering loneliness and social isolation.
One social scientist said it's clear from research that older adults are very motivated to keep social networks intact, and that positive social relations are beneficial to both physical and mental health. "This all suggests there is potential for health benefits for those who are using the Internet to enhance their social lives," added Lindsay Ryan, an assistant research scientist with the Institute for Social Research at the University of Michigan in Ann Arbor.
But what's the most effective way for older people to use the Internet to reach out to others? The study doesn't shed light on that question since the surveys didn't ask how participants used the Internet.
It's not clear whether email -- or using online chat rooms or bulletin boards -- made the most difference. Also, the backbones of social media today such as Facebook, Twitter and Instagram were in their infancy or nonexistent when the surveys were taken. MySpace was around, but older people didn't use it, Cotten said.
However, Cotten was co-author of a study released in 2012 that found older people who used Facebook and Twitter were one-third less likely to develop depression.
In the big picture, Cotten said, the new study reveals the value of the Internet to older adults. But there's a catch: They may need help mastering this 21st-century tool, she said.
"You can't put a piece of technology in front of them and tell them to go use it like you can with a child," she said. "You have to start from the beginning, even showing them how to turn on a computer, and show them how technology can be useful in their lives."
More information
Mental Health America has more on depression and the elderly (http://www.mentalhealthamerica.net/conditions/depression-older-adults ).
SOURCES: Shelia Cotten, Ph.D., professor, Department of Telecommunication, Information Studies, and Media, Michigan State University, East Lansing, Mich.; Lindsay Ryan, Ph.D., assistant research scientist, Institute for Social Research, University of Michigan, Ann Arbor; March 26, 2014, online, Journals of Gerontology, Series B: Psychological Sciences and Social Sciences

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